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Peds Exam 1 Textbook > Ch 16 (Cardio Essentials) > Flashcards

Ch 16 (Cardio Essentials) Flashcards

1
Q

most common peds cardiac defect

A

bicuspid aortic valve

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2
Q

most common cyanotic lesion

A

TOF

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3
Q

volume overload lesions are caused by ____________ shunting

A

L ➔ R

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4
Q

what kind of meds are beneficial in controlling pulmonary overcirculation and ensuring adequate systemic cardiac output

A

diuretics and afterload reducing agents

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5
Q

Conditions characterized by ductal-dependent systemic blood flow in the neonate include :

A
  • critical aortic stenosis
  • severe aortic coarctation
  • aortic arch interruption
  • hypoplastic left heart syndrome.
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6
Q

____________ maintains ductal patency and ensures adequate systemic blood flow until surgical or transcatheter intervention is performed

A

prostaglandin E1 therapy

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7
Q

In the neonate with ____________ , the pulmonary and systemic circulations operate in parallel rather than in the normal configuration in series

A

D-transposition of the great arteries

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8
Q

what is necessary to enhance inter circulatory mixing in some infants with transposition of the great arteries

A

balloon atrial septostomy

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9
Q

A common feature of single- ventricle lesions is …

A

complete mixing of the systemic and pulmonary venous blood at the atrial or ventricular level.

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10
Q

Defects with ____________ include those with ductal-dependent pulmonary blood flow

A

pulmonary outflow tract obstruction

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11
Q

The term cardiomyopathy refers to diseases of the

A

myocardium associated with cardiac dysfunction

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12
Q

hypertrophic cardiomyopathy (HCM) is characterized by…

A

ventricular hypertrophy without an identifiable hemodynamic cause that results in increased myocardial wall thickness

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13
Q

most children with HCM present for evaluation of..

A

a heart murmur, syncope, palpitations, or chest pain

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14
Q

dilated cardiomyopathy (DCM) is aka

A

congestive cardiomyopathy

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15
Q

DCM is characterized by (3)

A
  • thinning of the left ventricular myocardium
  • dilation of the ventricular cavity
  • systolic functional impairment
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16
Q

most children with DCM present with what kinds of s/s

A

signs and symptoms of congestive heart failure
- tachypnea
- tachycardia
- gallop rhythm
- diminished pulses
- hepatosplenomegaly

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17
Q

what kind of cardiomyopathy is least common and has a poor prognosis when it manifests in childhood

A

restrictive cardiomyopathy (RCM)

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18
Q

Myocarditis is defined as

A

inflammation of the myocardium, often associated with necrosis and myocyte degeneration.

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19
Q

myocarditis in the USA is most often caused by..

A

a viral infection

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20
Q

____________ and ____________ are the leading causes of death related to acquired cardiac disease in children

A

Acute rheumatic fever and rheumatic heart disease

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21
Q

Rheumatic fever results from ____________

A

infection by particular strains of group A β-hemolytic Streptococcus or Streptococcus pyogenes leading to a multisystemic inflammatory disorder.

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22
Q

The clinical diagnosis of rheumatic fever is based on ____________

A

the Jones criteria.

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23
Q

Primary prevention of rheumatic fever and rheumatic heart disease begins with ____________

A

prompt recognition and appropriate treatment of the initial streptococcal infection

24
Q

treatment of choice for most patients with streptococcal infection

A

Penicillin is considered the treatment of choice for most patients.

Secondary prevention with antibiotic prophylaxis is aimed at avoiding recurrences in individuals with a known history of rheumatic fever as they are considered at high risk.

25
Q

____________ has become the primary risk factor for IE in children in developed countries

A

CHD

26
Q

infective endocarditis infection results from…

A

deposition of bacteria or other pathogens on tissues in areas of abnormal or turbulent blood flow.

27
Q

The diagnosis of IE is made clinically by applying ____________

A

the modified Duke criteria

28
Q

Acute bacterial endocarditis is most commonly caused by ____________

A

Staphylococcus aureus.

29
Q

clinical manifestations of acute bacterial endocarditis

A

The clinical presentation includes high fevers, chills, myalgias, fatigue, and lethargy

30
Q

kawasaki disease patho

A
  • a fairly common and potentially fatal form of systemic vasculitis of unknown origin
  • It is a condition seen predominantly in infants and young children.
  • The disease can affect the coronary arteries resulting in dilation and aneurysmal formation.
31
Q

diagnosis of Kawasaki relies on clinical features, what are they?

A

To meet criteria, a child must have persistent fevers and at least four of the following findings:

  • Polymorphous exanthem
  • Peripheral extremity changes (e.g., erythema, desquamation, edema of the hands or feet)
  • Bilateral, nonexudative conjunctivitis
  • Cervical lymphadenopathy (often unilateral)
  • Oral changes (i.e., strawberry tongue; red, dry, or cracked lips)
32
Q

treatment during acute Kawasaki (2)

A

intravenous gamma globulin (IVIG) and high-dose aspirin are recommended during the acute phase of the disease

33
Q

During the first year of life, heart failure is predominantly caused by ____________

A

structural heart disease

34
Q

common clinical manifestations of heart failure in infants and young children

A
  • Tachypnea
  • Feeding difficulty (reflux, vomiting, feeding refusal)
  • Diaphoresis
  • Pallor
35
Q

common clinical manifestations of heart failure in older children and adolescents

A
  • Fatigue
  • Effort intolerance
  • Dyspnea
  • Orthopnea
  • Abdominal pain
  • Nausea
  • Vomiting
36
Q

main goal of therapy for acute heart failure

A

to maintain organ perfusion.

37
Q

favored agents for the treatment of heart failure in children

A

diuretics, including aldosterone antagonists, angiotensin-converting enzyme inhibitors, and β-blockers

38
Q

the most common chromosomal anomaly, occurring with a frequency of 1 per 800 live births

A

Trisomy 21

39
Q

trisomy 21 characteristics

A
  • Affected children are typically smaller than normal for age.
  • Craniofacial features include microbrachycephaly, short neck, oblique palpebral fissures, epicanthal folds, Brushfield spots, small and low-set ears, macroglossia, and microdontia with fused teeth.
  • Mandibular hypoplasia and flattened facial features are common. A narrow nasopharynx with hypertrophic lymphatic tissue (e.g., tonsils, adenoids) in combination with generalized hypotonia frequently leads to obstructive sleep apnea.
40
Q

____________ occur in 40% to 50% of children with Down syndrome, and it has been recommended that they all should undergo screening for CHD in early infancy

A

Cardiovascular defects

41
Q

____________ are the most common cardiac defects seen in children with down syndrome

A

The most common lesions include AV septal defects, VSDs, TOF, and PDA.

42
Q

second most common chromosomal trisomy

A

trisomy 18

43
Q

characteristics of T18

A
  • Most children exhibit microcephaly, delayed psychomotor development, and developmental delay
  • Characteristic craniofacial features include micrognathia or retrognathia and microstomia, which can affect airway management, as well as malformed ears, and microphthalmia.
44
Q

Cardiovascular disease, consisting primarily of ____________ , is present in most children with trisomy 18

A

VSDs and polyvalvular disease

45
Q

____________ is an uncommon autosomal trisomy with an incidence that ranges from 1 per 5000 to 12,000 live births

A

Trisomy 13 (Patau syndrome)

46
Q

major features of T13

A
  • Include cleft lip and palate, holoprosencephaly, polydactyly, rocker-bottom feet, microphthalmia, microcephaly, and severe developmental delay
  • Almost all children have associated cardiovascular defects, including PDA, septal defects, valve abnormalities, and dextrocardia.
  • The overall prognosis for these children is extremely poor.
47
Q

____________ is a genetic disorder characterized by partial or complete X chromosome monosomy

A

Turner syndrome

48
Q

features of Turner syndrome

A
  • Features of this syndrome include webbed neck, low- set ears, multiple pigmented nevi and micrognathia, lymphedema, short stature, and ovarian failure
  • Systemic manifestations include cardiac defects (notably aortic coarctation and bicuspid aortic valve), hypertension, hypercholesterolemia, renal anomalies, liver disease, and inflammatory bowel disease.
49
Q

Williams syndrome usually results from…

A

a deletion in the long arm of chromosome 7, altering the elastin gene.

50
Q

features of Williams syndrome

A

elfin facies, hypersocial personality, endocrine abnormalities (including hypercalcemia and hypothyroidism), developmental delay, growth deficiency, and altered neurodevelopment.

51
Q

Structural cardiovascular abnormalities, which occur in 80% of children with Williams syndrome , most commonly include:

A

valvar and supravalvular aortic stenosis

52
Q

what is noonan syndrome

A

one of a group of related conditions, collectively known as RASopathies or developmental syndromes of Ras/mitogen-activated protein kinase (MAPK) pathway dysregulation.

53
Q

dysmorphic features in Noonan syndrome

A

include neck webbing, low-set ears, chest deformities, hypertelorism, and short stature.

54
Q

Marfan syndrome

A

a multisystem disorder with variable expression resulting from a mutation in the fibrillin gene, a connective tissue protein, located on chromosome 15.

55
Q

clinical manifestations of Marfan syndrome

A

involve the cardiovascular, skeletal, and ocular systems.

  • MVP and regurgitation
  • ascending aortic dilation
  • main pulmonary artery dilation
56
Q

standard therapy and blood pressure control in children with aortic root dilation

A
  • ARBs
  • β- blockers
57
Q

CHARGE syndrome characteristics

A

coloboma
heart defects
choanal atresia
retardation of growth and development
genitourinary problems
ear abnormalities

Peds Exam 1 Textbook (7 decks)

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